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The Cost of Caring: The Impact of Dementia on Caregivers

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Dementia affects millions of individuals in the United States, and the number continues to grow. For military families, veterans, and federal employees, the impact of dementia often unfolds alongside the demands of service, relocation, deployment, or high-stress public service roles. Behind every diagnosis is a caregiver who provides daily support, often without formal training or adequate resources. Nearly 12 million Americans are caring for people living with Alzheimer’s disease or other dementias without being compensated, representing an economic value of more than 400 billion dollars. The emotional and physical cost, however, is far more difficult to measure. 

At Magellan Federal, we see the profound physical and emotional impact dementia has not only on those diagnosed but on the caregivers who walk beside them. This includes caregivers across military and federal communities who may already be navigating demanding missions, workforce pressures, or limited access to consistent support. As the population ages, the need to support caregivers becomes a national priority that directly affects family stability, workforce readiness, and long‑term wellbeing. 

The Changing Reality of Dementia Caregiving 

Caregivers today face increasing demands. 30% are 65 or older, 2/3 are women, and 1 in 4 is part of the sandwich generation, caring for both aging parents and children. Among military and federal families, caregiving responsibilities are often layered onto careers that require flexibility, mobility, and sustained performance. Their support allows individuals with dementia to remain at home longer and maintain a sense of dignity and independence. 

Caregiving can strengthen relationships and build resilience, yet it also brings emotional, physical, and financial strain. Compared to caregivers supporting individuals without dementia, dementia caregivers experience nearly double the rate of stress and health challenges. For caregivers in service-oriented environments, these risks can be compounded by operational demands and limited time for self-care. 

The Hidden Toll on Caregivers 

Dementia caregivers often report depression, anxiety, chronic stress, grief, and isolation. Many experience sleep disruption, weakened immune functioning, and increased risk of chronic illness. These challenges can be especially difficult for military families and federal employees who may be managing relocations, deployments, or high responsibility roles while providing care at home. 

The American Medical Association’s Caregiver Health Self‑Assessment Questionnaire highlights early signs of strain, such as irritability, fatigue, and difficulty concentrating. These symptoms are signals that caregivers need support, yet many caregivers, particularly those accustomed to prioritizing mission and service, push through until they reach burnout. 

Burnout and Compassion Fatigue 

Burnout reflects emotional, physical, and mental exhaustion caused by prolonged stress. Compassion fatigue develops when caregivers are repeatedly exposed to the suffering of someone they love. Both conditions can leave caregivers feeling numb, overwhelmed, or disconnected from their sense of purpose. 

These experiences are not personal shortcomings. They are predictable outcomes of a system that relies heavily on unpaid caregiving and limited support structures. For military and federal caregivers, cultural expectations around resilience and self-reliance can further delay help-seeking. 

Supporting Caregivers as Part of the Care System 

Magellan Federal advocates for a holistic approach that recognizes caregivers as essential partners in the dementia care journey. Federal agencies and military-connected systems have a unique opportunity to strengthen caregiver wellbeing across the populations they serve. 

  1. Acknowledge the Emotional Experience: Caregivers often feel guilt, grief, fear, and self‑doubt. Understanding the stages of dementia and the changes that come with each stage can help caregivers feel more prepared and less alone. This awareness is especially important in military and federal communities where emotional strain may be underrecognized. Validating their emotions is an important first step. 
  1. Strengthen Support Networks: Caregivers benefit from connection. National dementia organizations offer helplines, support groups, respite services, and educational resources that reduce isolation and help caregivers sustain their role over time. Ensuring these resources are accessible regardless of duty location or work schedule is critical for military and federal families. 
  1. Prioritize Caregiver Health: Caregivers need routines that support physical and mental wellbeing. Encouraging preventive care, behavioral health support, and caregiver‑friendly policies can reduce burnout and improve long-term outcomes. Workplace flexibility and leadership awareness play a meaningful role in supporting caregivers who are also part of the federal workforce. 
  1. Help Families Navigate Dementia Together: Families often struggle to talk about dementia, especially with children. Age‑appropriate resources and guidance can help normalize the experience and build resilience across generations. This support is particularly valuable for military children who may already be adapting to frequent change. 

Why Federal Leadership Matters 

Dementia caregiving is a public health challenge with far-reaching implications. Within military and federal populations, caregiver strain can directly affect readiness, retention, and overall workforce resilience. As the number of individuals living with dementia grows, so will the need for caregivers who are supported, trained, and emotionally equipped for the journey ahead. 

Federal agencies play a critical role in shaping the systems that support these caregivers. By investing in caregiver wellbeing, agencies strengthen workforce readiness, reduce long‑term healthcare costs, and enhance the stability of families who serve the nation. 

Magellan Federal is committed to advancing solutions that build caregiver resilience, expand access to behavioral health resources, and integrate caregiver support into federal programs. The cost of caring is high, but caregivers should not have to carry it alone. 

References:  

  • Oliveros, J. (2018). The Remember Balloons. Simon & Schuster. 
  • Fox, M. (1984). Wilfred Gordon McDonald Partridge. Kane/Miller Book Publishers. 
  • Elizabeth, J. (n.d.). Will Grammy Remember Me? (Publisher varies by edition.) 


What is Bibliotherapy?

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An Introduction to Supporting Kids with Storytelling 

Have you ever finished reading a book and felt like it somehow understood exactly what you were going through? Or maybe you’ve watched your child connect deeply with a character who was facing similar challenges? If so, you’ve experienced the power of bibliotherapy—and you might not have even realized it. 

What Exactly Is Bibliotherapy? 

Bibliotherapy is the practice of using books and literature as a therapeutic tool to help people work through emotional, psychological, and behavioral challenges. Think of it as counseling through storytelling. When we read about characters navigating difficult situations, we often find comfort, insight, and new ways of understanding our own experiences. 

This approach can be especially powerful with children, who naturally connect with stories and characters in ways that can help them process complex emotions and situations they might struggle to articulate on their own. 

Why Books Work So Well for Kids 

Reading aloud to children offers countless benefits beyond just entertainment. It strengthens the parent-child bond, supports development, and nurtures a lifelong love of learning. But when we use books therapeutically, something even more magical happens. 

Children’s books used in bibliotherapy can: 

  • Provide comfort during difficult times 
  • Normalize experiences that might feel overwhelming or isolating 
  • Validate feelings that children might not know how to express 
  • Teach coping skills through character examples 
  • Spark imagination and creative problem-solving 
  • Build empathy by showing different perspectives 
  • Develop social skills and emotional regulation 

Perhaps most importantly, books give parents a natural way to bring up challenging topics. Instead of having an awkward conversation out of nowhere, you can explore feelings and solutions alongside beloved characters. Children often find it easier to talk about what a character is experiencing before opening up about their own similar feelings. 

Perfect for Back-to-School Season 

With the school year upon us, bibliotherapy can be incredibly helpful for easing those back-to-school jitters. Whether your child is starting kindergarten or just feeling nervous about a new grade, the right book can make all the difference. 

Here are some tried-and-true favorites that tackle school-related anxiety: 

For the Nervous Newcomer: 

  • “First Day Jitters” by Julie Danneberg 
  • “The Kissing Hand” by Audrey Penn 
  • “The Night Before Kindergarten” by Natasha Wing 

For Building Confidence: 

  • “The Koala Who Could” by Rachel Bright 
  • “We’re All Wonders” by R.J. Palacio 
  • “The Day You Begin” by Jacqueline Woodson 

For Managing Big Feelings: 

  • “The Color Monster” by Anna Llenas 
  • “Ruby Finds a Worry” by Tom Percival 
  • “The Pigeon Has Feelings, Too!” by Mo Willems 

For Social Situations: 

  • “Strictly No Elephants” by Lisa Mantchev 
  • “Llama Llama Misses Mama” by Anna Dewdney 
  • “David Goes to School” by David Shannon 

It’s Not Just About Reading—It’s About Talking 

Here’s the key: bibliotherapy isn’t just about reading a book and calling it a day. The real magic happens in the conversations that follow. The story serves as a springboard for deeper discussions about feelings, experiences, and solutions. 

Try asking questions like: 

  • “What do you think this character is feeling right now?” 
  • “Have you ever felt the same way?” 
  • “What would you do if you were in this situation?” 
  • “What advice would you give this character?” 
  • “How do you think the story will end?” 

These questions help children process their own experiences through the safe lens of storytelling. 

Getting Started with Bibliotherapy 

Ready to give bibliotherapy a try? Start by thinking about what your child might be dealing with—whether it’s anxiety, friendship issues, big life changes, or just everyday emotional ups and downs. Then explore books that address those topics. 

The wonderful thing about children’s literature today is its incredible diversity. You can find books that tackle everything from everyday worries to more serious challenges like grief, illness, or family changes. The key is choosing books that are appropriate for your child’s age and developmental level. 

Where to Find the Right Books 

Not sure where to start? Your local library is a treasure trove of resources, and librarians are often incredibly knowledgeable about books for specific situations. You can also search online for curated lists—organizations like the Child Mind Institute, National Alliance on Mental Illness, Reach Out and Read, and Catalyst Kids offer excellent book recommendations organized by topic. 

The Bottom Line 

Bibliotherapy isn’t a replacement for professional help when it’s needed, but it’s a wonderful tool that every parent can use to support their child’s emotional well-being. Books have an incredible power to help us feel less alone, more understood, and better equipped to handle life’s challenges. 

So the next time you’re snuggled up for story time, remember: you’re not just reading a book—you’re opening up a world of healing, understanding, and connection. And that’s pretty amazing, isn’t it? 

References 

Kris, D. F. (2018). Why reading aloud to kids helps them thrive.

Lenkowsky, R. S. (1987). Bibliotherapy: A review and analysis of the literature. The Journal of Special Education, 21, 123-132. 

Rizza, M. (1997). A parent’s guide to helping children: Using bibliotherapy at home. The National Research Center on the Gifted and Talented. 



Fentanyl and the Opioid Epidemic

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The opioid epidemic is a significant public health problem in the United States. In 2021, over 75% of drug overdose deaths involved an opioid.[1] Between 2010 to 2019, drug overdose mortality rates have increased by 53% among U.S. military veterans.4 Opioids include prescription opioids, heroin, and synthetic opioids. About 150 individuals die each day from synthetic opioids. 2

Fentanyl is a synthetic opioid that has been associated with a significant number of overdoses in the U.S. It is considered to be “up to 50 times stronger than heroin and 100 times stronger than morphine”; thus, even small amounts of fentanyl can be deadly. 2 Pharmaceutical fentanyl has been prescribed for severe pain after surgery and with medical conditions such as cancer pain. Pharmaceutical fentanyl can be given as a patch, shot, or lozenge. Illegally manufactured fentanyl is found in liquid or powder form and is commonly mixed with other illicit substances or hidden to look like over-the-counter medications. Fentanyl is linked to a high number of overdoses and deaths. Between 2017 and 2021, fentanyl was involved in 52% of overdose cases in the military.5

Combating the Epidemic: Prevention and Treatment

The risk of overdose increases significantly when drugs are contaminated by or combined with fentanyl. Since it is difficult to taste, smell, or see fentanyl in other drugs, an individual may not know that fentanyl is present. Fentanyl test strips, used to detect whether fentanyl has been mixed with another drug, are available and can help prevent overdose. However, caution should be taken since these strips may not detect all forms of fentanyl, including carfentanil.2

Fentanyl is addictive and binds to the body’s opioid receptors in the brain, which control emotions and pain. Like natural opioids, fentanyl’s effects include drowsiness, confusion, difficulty breathing, unconsciousness, overdose, and death.3

How to Respond to an Overdose and Stay Informed

Individuals who use opioids as prescribed, those who abuse them, and persons in the general public should be aware of the signs of overdose as life-saving measures, such as halo one, are available. Signs and symptoms of an opioid overdose include small, constricted pinpoint pupils, loss of consciousness, slow or weakened breathing, cold or clammy skin, and discoloration of skin. When encountering someone who has overdosed, contact 911 immediately and administer naloxone when available.2

We recommend that persons using any form of opioids, and those who are likely to have contact with individuals using opioids, carry naloxone, which is now available over the counter and can be obtained at a pharmacy, through mail order, or through community risk reduction programs. Training for administering naloxone and learning about the opioid overdose epidemic is available, and additional information can be found through the VA’s Opioid Overdose Education and Naloxone Distribution Program (OEND), state or county health departments, GetNaloxoneNow, the CDC, and the American Red Cross.

The Military Health System and Defense Health Agency provide resources for opioid overdose education and naloxone distribution, including information for patients and caregivers. Additional toolkits and naloxone distribution videos are also provided by the U.S. Department of Veterans Affairs.

Resources

  1. Centers for Disease Control and Prevention (CDC). “Understanding the Opioid Overdoes Epidemic”. Last modified June 17, 2021, https://www.cdc.gov/opioids/basics/epidemic.html
  2. Centers for Disease Control and Prevention (CDC). “Fentanyl Facts”. Last modified September 6, 2023, https://www.cdc.gov/stopoverdose/fentanyl/index.html
  3. National Institute on Drug Abuse (NIH). “Fentanyl DrugFacts”. Last modified June 2021. https://nida.nih.gov/publications/drugfacts/fentanyl#:~:text=Naloxone%20is%20a%20medicine%20that,require%20multiple%20doses%20of%20naloxone
  4. Bennett, Alex S et al. “U.S. Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts.” Annals of medicine 54,1 (2022): 1826-1838. doi:10.1080/07853890.2022.2092896. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262363/
  5. Myers, Meghann. Military Times. “Fentanyl deaths among troops more than doubled from 2017 to 2021”. Last modified February 15, 2023, https://www.militarytimes.com/news/your-military/2023/02/15/fentanyl-deaths-among-troops-more-than-doubled-from-2017-to-2021/